BACKGROUND Familial idiopathic basal ganglia calcification (FIBGC) is a rare autosomal dominant disorder that causes bilateral calcification of the basal ganglia and/or cerebellar dentate nucleus, among other location...BACKGROUND Familial idiopathic basal ganglia calcification (FIBGC) is a rare autosomal dominant disorder that causes bilateral calcification of the basal ganglia and/or cerebellar dentate nucleus, among other locations. CASE SUMMARY The aim of this study is to report 10 cases of FIBGC observed in a single family. Seven patients showed calcification on their computed tomography scan, and all of these patients carried the SLC20A2 mutation. However, individuals without the mutation did not show calcification. Three patients among the 7 with calcification were symptomatic, while the remaining 4 patients were asymptomatic. Additionally, we longitudinally observed 10 subjects for ten years. In this paper, we mainly focus on the clinical course and neuroradiological findings in the proband and her son.CONCLUSION The accumulation of more case reports and further studies related to the manifestation of FIBGC are needed.展开更多
BACKGROUND Anastomotic leaks(AL)and gastric conduit necrosis(CN)are serious complications following oesophagectomy.Some studies have suggested that vascular calcification may be associated with an increased AL rate,bu...BACKGROUND Anastomotic leaks(AL)and gastric conduit necrosis(CN)are serious complications following oesophagectomy.Some studies have suggested that vascular calcification may be associated with an increased AL rate,but this has not been validated in a United Kingdom population.AIM To investigate whether vascular calcification identified on the pre-operative computed tomography(CT)scan is predictive of AL or CN.METHODS Routine pre-operative CT scans of 414 patients who underwent oesophagectomy for malignancy with oesophagogastric anastomosis at the Queen Elizabeth Hospital Birmingham between 2006 and 2018 were retrospectively analysed.Calcification of the proximal aorta,distal aorta,coeliac trunk and branches of the coeliac trunk was scored by two reviewers.The relationship between these calcification scores and occurrence of AL and CN was then analysed.The Esophagectomy Complications Consensus Group definition of AL and CN was used.RESULTS Complication data were available in n=411 patients,of whom 16.7%developed either AL(15.8%)or CN(3.4%).Rates of AL were significantly higher in female patients,at 23.0%,compared to 13.9%in males(P=0.047).CN was significantly more common in females,(8.0%vs 2.2%,P=0.014),patients with diabetes(10.6%vs 2.5%,P=0.014),a history of smoking(10.3%vs 2.3%,P=0.008),and a higher American Society of Anaesthesiologists grade(P=0.024).Out of the 14 conduit necroses,only 4 occurred without a concomitant AL.No statistically significant association was found between calcification of any of the vessels studied and either of these outcomes.Multivariable analyses were then performed to identify whether a combination of the calcification scores could be identified that would be significantly predictive of any of the outcomes.However,the stepwise approach did not select any factors for inclusion in the final models.The analysis was repeated for composite outcomes of those patients with either AL or CN(n=69,16.7%)and for those with both AL and CN(n=10,2.4%)and again,no significant associations were de展开更多
BACKGROUND High-speed rotational atherectomy (HSRA) is most commonly used to modify calcified coronary artery lesions to facilitate stent deployment and expansion. The use of HSRA as an emergency rescue technique to r...BACKGROUND High-speed rotational atherectomy (HSRA) is most commonly used to modify calcified coronary artery lesions to facilitate stent deployment and expansion. The use of HSRA as an emergency rescue technique to release a fractured microcatheter has not been described. We report the use of HSRA in a case of a fracture trapped corsair tip that was impeding coronary flow causing a ST elevation myocardial infarct. CASE SUMMARY A 79 years old male was scheduled for elective percutaneous coronary intervention (PCI) to his left anterior descending artery (LAD). Given its calcific nature, a decision was made for upfront rotablation. During procedural preparations, the tip of an employed micro-catheter was separated from the shaft resulting in obstructing coronary flow and ST-segment elevation. The consensus was for an attempt bail out PCI strategy. A rotafloppy wire was advanced to the distal LAD using a corsair micro-catheter which was placed proximal to the occlusion site. Modification of the mid LAD segment was performed, resulting in mobilising the corsair tip, and deflecting it to a small diagonal branch. Following serial predilation, the procedure was completed using two overlapping drug eluting stents, jailing the corsair tip in the diagonal branch. The patient made uneventful recovery and was clinically stable at one year follow up. CONCLUSION HSRA may be offered as a bailed-out strategy to rescue fractured and jailed micro-catheter tip in high risk surgical cases.展开更多
A novel process of calcification-leaching for bastnaesite concentrate(REFCO3) was proposed. The prior calcification was carried out in the system of NaOH-CaO-H2O and the lgC-pH pattern for Ce-F-Ca-C-H2O system was dra...A novel process of calcification-leaching for bastnaesite concentrate(REFCO3) was proposed. The prior calcification was carried out in the system of NaOH-CaO-H2O and the lgC-pH pattern for Ce-F-Ca-C-H2O system was drawn. The thermodynamics result indicates that decomposition for bastnaesite requires certain alkaline condition, but excessive alkalinity also causes decomposition of CaF2. XRD and SEM-EDS analyses on the calcification-leaching process reveal that bastnaesite first decomposes into RE(OH)3 and CaF2. Then, by HCl leaching rare earths were extracted,while CaF2 was left in the leaching residue. In addition, effects of temperature, time, NaOH and CaO on the calcification were investigated. The results show that the leaching rate of rare earths(REs)reaches 72.5 wt%, at the same time 99.2 wt% of F is left in leaching residue with 20 wt% NaOH and 38 wt% CaO at 493 K for 180 min.展开更多
In this study,the hypothesis that Wnt/β-catenin pathway is involved in the arterial calcification by regulating the osteoprotegerin(OPG)/receptor activator of NF-κB ligand(RANKL)system was tested.Theβ-catenin expre...In this study,the hypothesis that Wnt/β-catenin pathway is involved in the arterial calcification by regulating the osteoprotegerin(OPG)/receptor activator of NF-κB ligand(RANKL)system was tested.Theβ-catenin expression was measured in the warfarin-induced calcified arteries and the osteoblast-like cells differentiating from smooth muscle cells(SMCs)by immunohistochemistry and Western blotting.The Wnt/β-catenin pathway was activated or inhibited by lithium chloride(LiCl)or dickkopf 1(DKK1)in vitro and in vivo.Then the calcification level was determined by von Kossa staining,Ca^2+content assay,and alkaline phosphatase(ALP)activity assay.The expression levels of osteocalcin,OPG and RANKL were detected by Western blotting or real-time PCR.The results showed that in calcified arteries and OBL cells,the activation of Wnt/β-catenin pathway significantly enhanced the calcification as evidenced by increased von Kossa stains,Ca^2+contcnts,ALP activities,and osteocalcin expression levels(P<0.05),and it promoted the RANKL expression(P<0.05),but slightly affected the OPG expression.These results indicated that the activation of Wnt/β-catenin pathway worsens the arterial calcification,probably by promoting the RANKL expression.展开更多
基金the grant-in-Aid for Scientific Research (C) from the Japan Society for the Promotion of Science (JSPS), No. 17K103112.
文摘BACKGROUND Familial idiopathic basal ganglia calcification (FIBGC) is a rare autosomal dominant disorder that causes bilateral calcification of the basal ganglia and/or cerebellar dentate nucleus, among other locations. CASE SUMMARY The aim of this study is to report 10 cases of FIBGC observed in a single family. Seven patients showed calcification on their computed tomography scan, and all of these patients carried the SLC20A2 mutation. However, individuals without the mutation did not show calcification. Three patients among the 7 with calcification were symptomatic, while the remaining 4 patients were asymptomatic. Additionally, we longitudinally observed 10 subjects for ten years. In this paper, we mainly focus on the clinical course and neuroradiological findings in the proband and her son.CONCLUSION The accumulation of more case reports and further studies related to the manifestation of FIBGC are needed.
文摘BACKGROUND Anastomotic leaks(AL)and gastric conduit necrosis(CN)are serious complications following oesophagectomy.Some studies have suggested that vascular calcification may be associated with an increased AL rate,but this has not been validated in a United Kingdom population.AIM To investigate whether vascular calcification identified on the pre-operative computed tomography(CT)scan is predictive of AL or CN.METHODS Routine pre-operative CT scans of 414 patients who underwent oesophagectomy for malignancy with oesophagogastric anastomosis at the Queen Elizabeth Hospital Birmingham between 2006 and 2018 were retrospectively analysed.Calcification of the proximal aorta,distal aorta,coeliac trunk and branches of the coeliac trunk was scored by two reviewers.The relationship between these calcification scores and occurrence of AL and CN was then analysed.The Esophagectomy Complications Consensus Group definition of AL and CN was used.RESULTS Complication data were available in n=411 patients,of whom 16.7%developed either AL(15.8%)or CN(3.4%).Rates of AL were significantly higher in female patients,at 23.0%,compared to 13.9%in males(P=0.047).CN was significantly more common in females,(8.0%vs 2.2%,P=0.014),patients with diabetes(10.6%vs 2.5%,P=0.014),a history of smoking(10.3%vs 2.3%,P=0.008),and a higher American Society of Anaesthesiologists grade(P=0.024).Out of the 14 conduit necroses,only 4 occurred without a concomitant AL.No statistically significant association was found between calcification of any of the vessels studied and either of these outcomes.Multivariable analyses were then performed to identify whether a combination of the calcification scores could be identified that would be significantly predictive of any of the outcomes.However,the stepwise approach did not select any factors for inclusion in the final models.The analysis was repeated for composite outcomes of those patients with either AL or CN(n=69,16.7%)and for those with both AL and CN(n=10,2.4%)and again,no significant associations were de
文摘BACKGROUND High-speed rotational atherectomy (HSRA) is most commonly used to modify calcified coronary artery lesions to facilitate stent deployment and expansion. The use of HSRA as an emergency rescue technique to release a fractured microcatheter has not been described. We report the use of HSRA in a case of a fracture trapped corsair tip that was impeding coronary flow causing a ST elevation myocardial infarct. CASE SUMMARY A 79 years old male was scheduled for elective percutaneous coronary intervention (PCI) to his left anterior descending artery (LAD). Given its calcific nature, a decision was made for upfront rotablation. During procedural preparations, the tip of an employed micro-catheter was separated from the shaft resulting in obstructing coronary flow and ST-segment elevation. The consensus was for an attempt bail out PCI strategy. A rotafloppy wire was advanced to the distal LAD using a corsair micro-catheter which was placed proximal to the occlusion site. Modification of the mid LAD segment was performed, resulting in mobilising the corsair tip, and deflecting it to a small diagonal branch. Following serial predilation, the procedure was completed using two overlapping drug eluting stents, jailing the corsair tip in the diagonal branch. The patient made uneventful recovery and was clinically stable at one year follow up. CONCLUSION HSRA may be offered as a bailed-out strategy to rescue fractured and jailed micro-catheter tip in high risk surgical cases.
基金the Fundamental Research Funds for the Central Universities(973 program,No.N172506009,N170908001).
文摘A novel process of calcification-leaching for bastnaesite concentrate(REFCO3) was proposed. The prior calcification was carried out in the system of NaOH-CaO-H2O and the lgC-pH pattern for Ce-F-Ca-C-H2O system was drawn. The thermodynamics result indicates that decomposition for bastnaesite requires certain alkaline condition, but excessive alkalinity also causes decomposition of CaF2. XRD and SEM-EDS analyses on the calcification-leaching process reveal that bastnaesite first decomposes into RE(OH)3 and CaF2. Then, by HCl leaching rare earths were extracted,while CaF2 was left in the leaching residue. In addition, effects of temperature, time, NaOH and CaO on the calcification were investigated. The results show that the leaching rate of rare earths(REs)reaches 72.5 wt%, at the same time 99.2 wt% of F is left in leaching residue with 20 wt% NaOH and 38 wt% CaO at 493 K for 180 min.
文摘In this study,the hypothesis that Wnt/β-catenin pathway is involved in the arterial calcification by regulating the osteoprotegerin(OPG)/receptor activator of NF-κB ligand(RANKL)system was tested.Theβ-catenin expression was measured in the warfarin-induced calcified arteries and the osteoblast-like cells differentiating from smooth muscle cells(SMCs)by immunohistochemistry and Western blotting.The Wnt/β-catenin pathway was activated or inhibited by lithium chloride(LiCl)or dickkopf 1(DKK1)in vitro and in vivo.Then the calcification level was determined by von Kossa staining,Ca^2+content assay,and alkaline phosphatase(ALP)activity assay.The expression levels of osteocalcin,OPG and RANKL were detected by Western blotting or real-time PCR.The results showed that in calcified arteries and OBL cells,the activation of Wnt/β-catenin pathway significantly enhanced the calcification as evidenced by increased von Kossa stains,Ca^2+contcnts,ALP activities,and osteocalcin expression levels(P<0.05),and it promoted the RANKL expression(P<0.05),but slightly affected the OPG expression.These results indicated that the activation of Wnt/β-catenin pathway worsens the arterial calcification,probably by promoting the RANKL expression.